Brain tumors are found in patients of any age, and they vary in aggressiveness, or speed of growth. Tumors can arise in any part of the brain, confined to a single area or infiltrating several areas. For these reasons, treatment of brain tumors must be tailored to each individual patient. The location of the tumor, the age, general condition of the patient, and the clinical diagnosis (determined from diagnostic imaging tests) are all important treatment considerations.
Brain tumors are often diagnosed with magnetic resonance imaging (MRI) and/or computed tomography (CT). With modern scans, special sequences can help the clinician predict the specific type of tumor. It is rarely possible, however, to be absolutely certain of the tumor type without a biopsy. Once tissue has been obtained from a biopsy, the pathologist can inspect it under a microscope and make a definite diagnosis.
Depending on the location of the tumor within the brain, it may be possible to perform a craniotomy, an operation to remove a large amount of the tumor. Tumors deep in the brain, which may be difficult to reach surgically, can be safely operated on using navigation techniques. These techniques allow computers to guide the surgeon to small, deep tumors, using precisely placed probes, with minimal disruption to normal brain tissue. When a craniotomy does not seem appropriate for the patient, the tumor can be biopsied using stereotactic techniques. This allows the surgeon to obtain tissue in a safe, minimally invasive manner. For patients with a residual tumor, it is possible to treat the tumor with radiation therapy and chemotherapy. Radiation therapy, either in conventional form or using focused radiation (also called stereotactic radiosurgery), is often the next step in the treatment plan. Radiosurgery has been used to treat both malignant and benign tumors that might otherwise be surgically irremovable. Lahey Hospital & Medical Center uses a modified linear accelerator to deliver this "pinpoint" radiation to the areas deep within the brain without injuring the surrounding brain structures. In addition to radiation, a patient may be treated with various chemotherapy agents. Patients continue to be followed in the Brain Tumor Clinic throughout their treatment course. Peter Dempsey, MD, leads our brain tumor effort and is joined by neuro-oncologists who provide our patients with the best available chemotherapeutic agents using both standard treatment and the latest protocols.